The relation between chondromalacia patella and meniscal tear and the sulcus angle/ trochlear depth ratio as a powerful predictor

Article type: Research Article

Authors: Resorlu, Hatice^{a; *} | Zateri, Coskun^a | Nusran, Gurdal^b | Goksel, Ferdi^b | Aylanc, Nilufer^c

Affiliations: [a] Department of Physical Medicine and Rehabilitation, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey | [b] Department of Orthopeadics and Traumatology, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey | [c] Department of Radiology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey

Correspondence: [*] Corresponding author: Hatice Resorlu, Canakkale Onsekiz Mart University, Terzioglu Yerleskesi, Barbaros Mh, 17100, Canakkale, Turkey. Tel.: +90 505 454 8721/+90 286 2180393; E-mail: [email protected]

Abstract: PURPOSE: To investigate the relation between chondromalacia patella and the sulcus angle/trochlear depth ratio as a marker of trochlear morphology. In addition, we also planned to show the relationship between meniscus damage, subcutaneous adipose tissue thickness as a marker of obesity, patellar tilt angle and chondromalacia patella. METHODS: Patients with trauma, rheumatologic disease, a history of knee surgery and patellar variations such as patella alba and patella baja were excluded. Magnetic resonance images of the knees of 200 patients were evaluated. Trochlear morphology from standardized levels, patellar tilt angle, lateral/medial facet ratio, subcutaneous adipose tissue thickness from 3 locations and meniscus injury were assessed by two specialist radiologists. RESULTS: Retropatellar cartilage was normal in 108 patients (54%) at radiological evaluation, while chondromalacia patella was determined in 92 (46%) cases. Trochlear sulcus angle and prepatellar subcutaneous adipose tissue thickness were significantly high in patients with chondromalacia patella, while trochlear depth and lateral patellar tilt angle were low. The trochlear sulcus angle/trochlear depth ratio was also high in chondromalacia patella and was identified as an independent risk factor at regression analysis. Additionally, medial meniscal tear was observed in 35 patients (38%) in the chondromalacia patella group and in 27 patients (25%) in the normal group, the difference being statistically significant (P = 0.033). CONCLUSIONS: An increased trochlear sulcus angle/trochlear depth ratio is a significant predictor of chondromalacia patella. Medial meniscus injury is more prevalent in patients with chondromalacia patella in association with impairment in knee biomechanics and the degenerative process.

Keywords: Chondromalacia patella, meniscal tear, trochlear morphology

DOI: 10.3233/BMR-160536

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 3, pp. 603-608, 2017